| NPI | 1427441260 |
|---|---|
| Former Name | AMANDA M KUBICEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 101502) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 81455) |
| 167G00000X Licensed Psychiatric Technician (Licence: CA 37965) | |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2021-06-14 |